Sunday, July 16, 2017

Birth Wisdom

Until one experiences natural childbirth firsthand, there’s really no way to anticipate what it entails. You can do all the reading, all the watching, and all the listening to those who previously went through the gauntlet, but none of it truly captures the one-of-a-kind nature that is untamed birth. You have to simply go through it to really understand it.

Just shy of 3 years ago, my daughter Scarlet was born. It was a planned unmedicated home birth, which ended up in a hospital transport due to maternal exhaustion. Upon much reflection, there were a variety of lessons we drew from Scarlet’s birth (see here) - lessons we fully intended to implement when it came time to have our second child. So when we conceived back in October of 2016, we felt like fighters training for a rematch. It would be entirely different this time around, and we would be ready to go the distance and then some, if necessary.

As before, Heather was focused on “preparing her vessel” prior to conception. This entailed optimal nutrition, exercise, sleep, etc, which continued throughout the entire pregnancy. Her diet was clean the first time around, but it was cleaner this time. She swam and aggressively walked while pregnant with Scarlet, but now she mixed in yoga and a whole lot of floor sitting, in order to maintain her hip flexibility and pelvic range of motion, which she knew would be critical during labor. Once more, she continued regularly seeing an acupuncturist, but this time she also consistently saw an osteopath, who was vital in maintaining a robust musculoskeletal structure and tendon / joint health all throughout the pregnancy - this in turn allowed Heather to maintain a higher level of activity than she would otherwise have been able to, evidenced by her attending yoga classes all the way into her 41st week of pregnancy.

Of course, having to take care of a toddler during pregnancy makes physical and mental preparation of any kind considerably more difficult to accomplish. But she did everything she could given the circumstances, which is all one can ever do. Funnily enough, in contrast to our first pregnancy, where we read everything we could get our hands on, with the second pregnancy we read little to almost nothing, because ultimately there is no better preparation than having actually lived through birth before. Plus, reading becomes untenable once tiny humans are running around and screeching all day long.

So we were ready to go, and on July 7th, 2017, four days past her “due date”, the time was upon us. After days of intermittent mild contractions, 9 AM brought a new variety. These required focus. Active labor had begun.

Thankfully, we had both slept for 7-8 hours, and that morning Heather ate like a champ while she had the capacity to do so. Both of these paid dividends down the line.

For the first 2-3 hours, we were on our own. Heather had opened up the windows and patio door, allowing a cool breeze to flow through the house along with the sound of the morning rain, which she found soothing as she labored on the floor of our dining room. During a contraction, I’d put extreme pressure on her sacrum which aided her ability to navigate the discomfort, while she vocalized and focused on her breathing.

Labor vocalization is definitely a distinct sound - it’s somewhere between a Tibetan chant and a dying animal - and it’s a little strange when one’s exposure to this sound inevitably ceases to be odd.

Eventually our doula and midwives arrived, joined shortly thereafter by Heather’s osteopath. Birth team fully assembled, the hard work continued. Any time her vocalizations started to creep up in tone, she was hit with constant reminders: “keep it low Heather”, “don’t tense up”, “stay relaxed”, “let it resonate downwards”, “let it in”, etc.

I moved the dining room table into the corner, and we set up a birthing pool in its place, allowing Heather to knock out the next couple of hours immersed in warm water, while the osteopath worked on Heather’s back and legs.

Then the party moved into our bedroom. Squatting on a small birth stool, Heather’s vocalizations reached a new level of intensity, and she started saying affirmations at the onset of each new wave of contractions - “my body and baby know how to birth” - after which she would lean backwards into my arms and go limp, while I massaged her lower back.

Time has a habit of skewing in labor (even for birth partners), so I don’t really know how long it was before the midwife explained that she was almost fully dilated at 9 cm. The caveat was that there was a small patch of cervix stubbornly hanging on, preventing the baby from moving downwards. Feeling wiped out, Heather opted to move to the bed for a momentary reprieve.

FYI, this was not just any bed - it was an organic bed that sat atop a hi tech frame, capable of independently moving the head and feet sections upwards. Put differently, it was a bed tailored for labor! And that is exactly what went through our minds when bed shopping the previous year - all things being equal, always go with the bed that will best facilitate a birth!

After a few rounds of contractions lying down, the midwife explained she could attempt to manually push back that last bit of cervix during the next contraction, if Heather wanted; otherwise, Heather should get back to being upright so as to let gravity better assist with the remaining inch of dilation. Unsure of how to proceed, and since she was already on the bed, Heather instructed the midwife to take a shot at the manual adjustment. And then she let out a blood curdling scream when that adjustment was attempted. Having failed to accomplish the goal, and feeling the sensation was entirely unnatural, Heather opted for plan B - back on the feet we would go, but not before her water finally broke in the midst of another contraction, an explosion that took everyone by surprise (as I suspect it probably often does).

Now on her feet, we made our way into the bathroom, where Heather sat on the toilet. The toilet may strike some as an odd birthing location, but it’s where people habitually go to relax their sphincter, and actually makes for a good labor site. At this point, Heather was beyond fatigued, and she was sort of swaying in front of me like a drunken sailor from utter exhaustion. She kept repeating, “I don’t think I can do this” … and we kept repeating, “yes you can - you’re already doing it”.

Sensing we were at a crucial precipice, where her focus and willpower could potentially get carried away from her, I asked the doula to trade places with me. Then I ran into the kitchen and grabbed an iPod off the counter that contained a playlist of music we had curated specifically for if / when we reached a point like this. Ear buds secure, I hit play - then she went totally silent for the next 10-15 minutes, breathing through the contractions without vocalizing. I could see her energy recharging, catching a second wind. It was fascinating to watch.

The midwives and doula then suggested that she get into the shower. After some initial protest, Heather begrudgingly relented. Ear buds removed, I assisted her into the shower. As soon as the water hit her body, she said it felt good and asked that we make it colder, which we obliged. And cold it got … like really fucking cold … like the kind of water polar bears approve of cold … like a shower that could offset climate change cold.

I was standing directly in front of her, as a leaning post, and when she had a contraction she would drop into a squat while I supported her underneath her arms. Cleverly, the midwives’ assistant gave me a towel to put around my neck for Heather to grab onto, and with which I could more efficiently support her.

After some amount of time in the shower, one of the midwives attempted to check her progress but was unable to get an accurate assessment, due to the confined space of the shower stall. So ironically, now to Heather’s great dismay, she begrudgingly got out of the shower and back into the open space of our bedroom.

The towel remained around my neck and shoulders, and we kept the same stand-squat routine going. As if in anticipation, the sun had by now reared its head outside, casting a beautiful shimmer over the trees, and it wasn’t long before the midwife proclaimed the cervix had fully receded and the head was descending. On we went. I suddenly realized that the midwife was directly behind me, on her hands and knees, in between my legs, checking the baby’s progress between Heather’s legs. It was like a game of Birth Twister.

Midwife: “Zack, please don’t sit on me”

Me: ”Susan, I would never sit on you”.

Heather: “Is that the head out?”

Midwife: “Yes it is!”

Heather: “Ok, is everyone ready?”

Birth Team: “Yes!”

The fog of labor was instantaneously lifted as the baby was birthed, preceded only by the warmest gush of fluid across my legs I have ever felt … like wonderfully warm … like water befitting a tropical desert paradise warm … like the kind of water those Japanese snow monkeys submerge themselves in to escape a merciless winter warm. Yes, I felt like a Japanese snow monkey on holiday.

As the baby was caught by the midwife between my legs, and handed upward between myself and Heather, I was jolted back to reality as the baby screeched, and I was perplexed at the extreme pale white appearance. “My God, she’s birthed a White Walker!” I thought to myself. As it turns out, it was just the vernix (which apparently was unusually plentiful for a full term baby). Soon thereafter, with vernix rubbed into the skin, the baby pinked up just fine.

And so it is with great delight that I introduce you to Willow Sky Hemsey:

In the aftermath of our first birth, I was surprised at some of the confusion (and borderline outrage) I received in response to what happened. Some felt our attempted home birth was irresponsible and dangerous, despite no one actually being in danger of anything at any point. Some felt it was masochistic to have an unmedicated birth and/or that we were trying to prove something (it wasn’t and we weren’t). Some felt we were exhibiting an unnecessary disdain or disregard for western medicine and/or technology (again, we weren’t). And some expressed incredulity that we would attempt another home birth after what had happened the first time, as if our birth with Scarlet was physically or mentally traumatic in nature (it wasn’t … it was crushing psychologically to not get the birth we had wanted, but it remained a positive experience on the whole, for both of us).

I found it bizarre (and still do) that so many completely miss the spirit of our actions. The desire to birth at home stems from a desire to birth naturally, unmedicated, in a familiar, comfortable, and safe environment. For us, that’s home. For you, it may be a hospital. In turn, the desire to birth naturally without medication stems from the physiological benefits of doing so, for both baby and mother (the reader can take it upon themselves to research this, or reference my response to the initial comment on Birth Lessons where I go into greater depth). Importantly, being unmedicated prevents the natural birth process from being inadvertently undermined and short-circuited, for it maximizes the mother’s ability to coherently and effectively navigate birth, which then minimizes the potential need for interventions (and the domino effect of complications and further interventions that can often ensue as a result).

But there is an additional component to unmedicated natural childbirth that goes beyond the physiology, and it has nothing to do with pain or suffering. It’s about embracing the enormity of what the human body is designed to do, completely unfiltered and raw. It’s about surrendering to a process that evades our comprehension, without fear or anxiety. And it’s about feeling the connection between mother, baby, and body, and tapping into the extraordinary potential of the human psyche. It is uniquely transformative, capable of changing even those merely in proximity to it.

Of course, birth is not the only one-of-a-kind experience that exists. I imagine there’s probably nothing like free falling through the sky after jumping off a plane or mountaintop, or being in outer space, or climbing Mt Everest, etc. There is a diverse tapestry of rich and immensely powerful experiences humans are capable of encountering. But birth in its purest form may very well be the most challenging and exhilarating human event there is. It is riding a tidal wave toward the brink of your capacity, and then miraculously going beyond it. And it is a rite of passage for anyone wishing to come into direct contact with the essence of life itself.

When it was all over and done, Heather said the birth was the single greatest experience of her life.

Congratulations to you, Scarlett and the Amazing Heather bringing Willow into your family. That was well written and descriptive story, I felt like part of the team for a second and needed a line to add into the game of Birth Twister.

It was sad to hear you had a bit of backlash over Scarlett's birth. It goes to show how people tend to think purely of their own experience with lack of real knowledge of who they are dealing with. After knowing you for many, many years, You and Heather put a lot of effort into everything you do. Not for a minute would I think you two would ever go this route if you didn't firmly believe it was the right way and done safely. Conditioned as we are here in the US, we can be forced into believing there is one way while eliminating other greater possibilities to produce the same result. While this form of birth was more common before western medicine and methods had been implemented, it still exits around the world and possibly with less preparation as you guys put forth. I am sure some women would love to have a team by their side to cheer them on. As you mentioned with enough preparation both physically and mentally, what Heather, you and the team pulled off is absolutely beautiful. Heck even a great story to tell Willow one day. The entire experience of having a child is amazing, why not start it off with something more intro with your family dynamic.

What a beautiful tribute to your journey as you and Heather cultivated, nurtured, and embraced your strength, love and resilience with focus and intention. You both worked so hard to achieve this goal and I was blessed to be a witness and helping hand. As you so eloquently wrote, "...birth in its purest form may very well be the most challenging and exhilarating human event there is. It is riding a tidal wave toward the brink of your capacity, and then miraculously going beyond it."

That you did, and more! Hold onto that sense of strength and empowerment as you continue on your journey as I am certain it will come in handy again.... much love to all of you, Jen